title: Reverse total shoulder arthroplasty in patients of varying body mass index.
abstract: BACKGROUND
  Body mass index (BMI) is an independent predictor of complications after hip and knee arthroplasty. Whether similar trends apply to patients undergoing reverse total shoulder arthroplasty (RTSA) is unknown.
  
  
  METHODS
  A retrospective review of primary RTSAs with a minimum 90-day follow-up were included. Complications were classified as major or minor and medical or surgical. Patients were classified into 3 groups: normal BMI (BMI <25 kg/m(2)), overweight or mildly obese (BMI 25-35 kg/m(2)), and moderately or severely obese (BMI >35 kg/m(2)).
  
  
  RESULTS
  Of the 119 patients met our inclusion criteria, 30 (25%) had a BMI of less than 25 kg/m(2); 65 (55%) had a BMI of 25 to 35 kg/m(2), and 24 (20%) had BMI exceeding 35 kg/m(2). Complications occurred in 30 patients (25%), comprising major in 11 (9%), minor in 19 (16%), surgical in 21 (18%), and medical in 14 (12%). The most common surgical complications were acute blood loss anemia requiring transfusion (8.4%) and dislocation (4.2%). The most common medical complications were atelectasis (2.5%) and acute renal insufficiency (2.5%). Patients with a BMI exceeding 35 kg/m(2) had a significantly higher overall complication rate (P < .05) and intraoperative blood loss (P = .05) than the other groups. Patients with BMI of less than 25 kg/m(2) had a greater overall complication rate than those with a BMI of 25 to 35 kg/m(2) (P < .05). Multivariate regression analysis demonstrated BMI was the only significant determinant of overall complication rates and medical complication rates (P < .05).
  
  
  CONCLUSIONS
  Patients with a BMI exceeding 35 kg/m(2) (severely obese) or a BMI of less than 25 kg/m(2) have higher rates of complication after RTSA.
authors.affiliation: Section of Shoulder and Elbow Surgery, Midwest Orthopaedics at Rush, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA. Electronic address: anilgupta07@hotmail.com.
authors.forename: Anil K
authors.initials: AK
authors.lastname: Gupta
authors.affiliation: Section of Shoulder and Elbow Surgery, Midwest Orthopaedics at Rush, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Peter N
authors.initials: PN
authors.lastname: Chalmers
authors.affiliation: Section of Shoulder and Elbow Surgery, Midwest Orthopaedics at Rush, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Zain
authors.initials: Z
authors.lastname: Rahman
authors.affiliation: Section of Shoulder and Elbow Surgery, Midwest Orthopaedics at Rush, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bruce
authors.affiliation: Section of Shoulder and Elbow Surgery, Midwest Orthopaedics at Rush, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Harris
authors.affiliation: Section of Shoulder and Elbow Surgery, Midwest Orthopaedics at Rush, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: McCormick
authors.affiliation: Section of Shoulder and Elbow Surgery, Midwest Orthopaedics at Rush, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Geoffrey D
authors.initials: GD
authors.lastname: Abrams
authors.affiliation: Section of Shoulder and Elbow Surgery, Midwest Orthopaedics at Rush, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Nicholson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D012785:Shoulder Joint / Q000601:surgery*
keywords: Complications; Level III; Retrospective Cohort Study; Treatment Study; medical; obesity; reverse total shoulder arthroplasty; surgical